Background: As part of the residency application process in the United States, many medical specialties now offer applicants the opportunity to send program signals that indicate high interest to a limited number of residency programs. To determine which residency programs to apply to, and which programs to send signals to, applicants need accurate information to determine which programs align with their future training goals. Most applicants use a program's website to review program characteristics and criteria, so describing the current state of residency program websites can inform programs of best practices. Objective: This study aims to characterize information available on obstetrics and gynecology residency program websites and to determine whether there are differences in information available between different types of residency programs. Methods: This was a cross-sectional observational study of all US obstetrics and gynecology residency program website content. The authorship group identified factors that would be useful for residency applicants around program demographics and learner trajectories; application criteria including standardized testing metrics, residency statistics, and benefits; and diversity, equity, and inclusion mission statements and values. Two authors examined all available websites from November 2011 through March 2022. Data analysis consisted of descriptive statistics and one-way ANOVA, with P <.05 considered significant. Results: Among 290 programs, 283 (97.6%) had websites; 238 (82.1%) listed medical schools of current residents; 158 (54.5%) described residency alumni trajectories; 107 (36.9%) included guidance related to the preferred United States Medical Licensing Examination Step 1 scores; 53 (18.3%) included guidance related to the Comprehensive Osteopathic Medical Licensing Examination Level 1 scores; 185 (63.8%) included international applicant guidance; 132 (45.5%) included a program-specific mission statement; 84 (29%) included a diversity, equity, and inclusion statement; and 167 (57.6%) included program-specific media or links to program social media on their websites. University-based programs were more likely to include a variety of information compared to community-based university-affiliated and community-based programs, including medical schools of current residents (113/123, 91.9%, university-based; 85/111, 76.6%, community-based university-affiliated; 40/56, 71.4%, community-based; P <.001); alumni trajectories (90/123, 73.2%, university-based; 51/111, 45.9%, community- based university-affiliated; 17/56, 30.4%, community-based; P <.001); the United States Medical Licensing Examination Step 1 score guidance (58/123, 47.2%, university-based; 36/111, 32.4%, community-based university-affiliated; 13/56, 23.2%, community-based; P =.004); and diversity, equity, and inclusion statements (57/123, 46.3%, university-based; 19/111, 17.1%, community-based university-affiliated; 8/56, 14.3%, community-based; P <.001). Conclusions: There are opportunities to improve the quantity and quality of data on residency websites. From this work, we propose best practices for what information should be included on residency websites that will enable applicants to make informed decisions.

INTRODUCTION: National guidelines recommend the Tdap vaccine during 27-36 weeks gestation to confer immunity to the neonate. At the University of New Mexico, Title V-funded clinics that provide prenatal care for uninsured women do not provide on-site Tdap, but refer women to the Department of Health (DOH) for vaccination. Other university clinics stock the vaccine on-site. We sought to compare rates at Title V clinics to university-based obstetrical and family medicine clinics. METHODS: A retrospective review of electronic health records was performed for women who received prenatal care at Title V, obstetric, and family medicine clinics in 2018. Patients were crossed checked in the New Mexico Statewide Immunization Information System to include DOH records. Statistical significance was assessed using two-sample tests of proportion and a logistic regression. RESULTS: Results from 372 charts revealed the rate for Title V clinics (31.94%) was significantly lower than the rates for obstetrical clinics (71.91%, P<.02) and family medicine clinics (90%, P<.001). Controlling for demographic factors, women at Title V clinics were 80% less likely to get a Tdap vaccine than women who went to obstetric clinics (P<.001). CONCLUSION: Title V clinic patients are less likely to receive Tdap than patients who receive care at clinics with Tdap on-site. Providing on-site Tdap vaccination for uninsured pregnant women is a matter of health equity. Advocating for change by addressing specific barriers is ongoing. The results of this study have guided a comprehensive quality improvement project, resulted in the donation of on-site vaccines, and inspired a larger DOH study.

PROBLEM: The UNM OB/Gyn residency program has never implemented a formal mentoring program. Each resident was asked to choose a mentor during their intern year, but no expectations were established or accountability provided for this relationship. Because interns were asked to choose their mentors, the same small pool of mentors was repeatedly chosen and caused mentor fatigue. Struggling residents found it difficult to receive the mentoring they required. Excelling residents often had minimal contact with their mentors. INTERVENTION: An evidenced-based formal mentoring program was implemented in March 2018. This includes group mentoring for the first 18 months of residency and individual mentors for the remaining 2.5 years. Mentorship pairs sign a formal mentorship agreement, develop specific goals and objectives to achieve prior to their next meeting, and give written feedback on their relationship. Group mentoring covers a reading curriculum on: Transitioning from student to doctor (September), Work/Life balance (December), Discrimination in medicine (March), Coping with poor patient outcomes (June). CONTEXT: Faculty have increasing clinical productivity demands and often do not have time to meet with mentees. Residents must maintain an 80 hour work week. In light of these time constraints we conduct group mentoring and mentor/mentee pair meetings during the usual Grand Rounds hour once each quarter. As the Department develops a faculty compensation plan, these meetings will earn EVUs. OUTCOME/LESSONS LEARNED: Initial satisfaction has been high. The first group of R2s have chosen their personal mentors and includes more subspecialists. Administrative support is needed to track completion of required tasks.

Team-based care in the outpatient women's health setting has the potential to help alleviate the demand for women's health care providers and to deliver improved quality of care to the growing population of US women. Although teamwork is necessary in the current health care system, most of the current obstetrics and gynecology and advanced practice provider (APP) workforce were not trained for collaborative practice. Core competencies for building an effective outpatient women's health care team are explained and current evidence regarding the specific role of APPs in women's health care is reviewed.

PURPOSE: Our primary aim was to evaluate the effects of a formalized wellness curriculum on the rate of burnout among University of New Mexico (UNM) obstetrics and gynecology (OBGyn) residents. Our secondary aim was to evaluate the effect of a wellness curriculum on rates of depression, alcohol abuse and suicide risk. BACKGROUND: Burnout is a pathological syndrome characterized by depersonalization, emotional exhaustion and a low sense of personal achievement. Burnout is a concern for resident physicians due to their heavy workload and low sense of autonomy. METHODS: A structured wellness curriculum was instituted at the start of the 2016 academic year. A 45-item survey, consisting of the Maslach Burnout Inventory Human Services Survey (MBI-HSS), personal health questionnaire-9 (PHQ9), suicide behaviors questionnaire-revised (SBQr), and the alcohol use disorders identification test (AUDIT), was to be administered at the start, midpoint, and end of the academic year. RESULTS: The study included 23 UNM OBGyn residents. Midpoint and end of curriculum surveys were collected as planned and demonstrated no difference in rate of burnout. Upon completion of the 2016 academic year 18 (78.2%) residents reported moderate to severe emotional exhaustion; 13 (59.1%) moderate to severe depersonalization; and 5 (21.7%) low personal achievement. SBQ-R identified 4 (18.2%) residents at high risk for suicide and AUDIT-C identified 15 (68.2%) at high risk for alcohol abuse. DISCUSSION: High rates of burnout, depression, alcohol abuse, and suicide risk did not change between the midpoint and end of a structured wellness curriculum.

Projections of supply and demand for obstetricians-gynecologists suggest a current minimal or modest shortage that will worsen in the future. The US adult female population is expected to increase by more than 20% by 2045 and represents a key driver for increased demand for health care services. The annual number of obstetrician-gynecologists (ob-gyn) residency graduates has increased negligibly, whereas the proportion accepted into fellowships increased steadily, reducing those in general practice. The gradual increase in proportion of ob-gyns who are women coincides with desires for more work-life balance and earlier retirement from clinical practice. As the supply of advanced practice providers of women’s health services grows, the need for more ob-gyns could be less to meet the projected demand.

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INTRODUCTION: Concerns have been raised that the number of residents in obstetrics and gynecology (ob-gyn) is inadequate to meet the growing adult female population in the U.S. The objective of this study was to examine the estimated adult female population in relation to the number of first-year ob-gyn residency positions over the most recent 24-year period. METHODS: This descriptive study examined data from the National Residency Match Program and the U.S. Census Bureau, population division. The study period began in academic year 1992, when complete data about accredited residency positions first became available and ended with the most recent report in 2015. The numbers of residency programs and positions and the middle estimated population of females >18 year old were sought annually. RESULTS: The number of accredited programs declined (from 257 in 1992 to 242 in 2015), while the number of first-year positions increased minimally from 1,110 in 1992 to 1,255 in 2015 (0.8% increased compounded annually). Growth in the U.S. adult female population rose from 89.5 million to 123.1 million (1.8% increased compounded annually). The number of U.S. females >18 years old for every first-year residency position increased by 1.8% annually from 80,630 in 1992 to 98,088 in 2015. CONCLUSION: A minimal increase in the number of first-year residency positions in ob-gyn was outpaced by a steady growth in the U.S. adult female population. This finding emphasizes the need for greater collaboration between ob-gyns and other providers as demand for women's health care is expected to increase.

We present a case in which an emergency medical services (EMS) crew was called for a precipitous breech delivery with fetal head entrapment that was unrelieved following standard prehospital interventions and eventually resulted in neonatal cardiac arrest and death. Although this is a rare occurrence, EMS responders must have adequate training and guidelines on how to assist with vaginal delivery of breech presentation and how to appropriately manage fetal head entrapment in the field. There is little literature to provide guidance but it appears that standard EMS teaching does not represent current best obstetrical practice. We review the available literature, make expert recommendations, and provide a sample new treatment guideline for basic life support, advanced life support, and EMS physician response.

Cervical cancer is the most commonly diagnosed malignancy during pregnancy with an incidence of 1.5 to 12 per 100,000 pregnancies. In the United States between 2% and 7% of all pregnant women will have an abnormal Pap test. The management of these abnormal results during pregnancy can present a challenge to the practitioner. This article reviews recently published guidelines and current evidence for evaluation and management of abnormal cervical cytology and cervical cancer in pregnancy.

OBJECTIVE:The objective of this study was to determine the proportion of postpartum women at the University of New Mexico who choose an IUD for contraception, the number who actually obtain one and the barriers to postpartum IUD insertion. METHOD:We conducted a retrospective chart review of 1627 postpartum women who delivered at the University of New Mexico. Those women who indicated at hospital discharge that they desired an IUD comprised the study group of 193 women. Medical records were reviewed to identify the timing of IUD placement. If an IUD was not inserted, we attempted to determine the reason by reviewing clinic records. RESULTS:Twelve percent of postpartum women requested an IUD. Records were available for 114 women. Of these, only 69 (60%) actually obtained an IUD. Barriers to postpartum IUD insertion included provider advice against the IUD, patient failure to return for a postpartum visit and early repeat pregnancy. CONCLUSION:We conclude that postpartum women desiring an IUD may have difficulty obtaining one.